Provider Demographics
NPI:1891061560
Name:ALLEN, BARBARA JEANNE
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JEANNE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 NE SUNSET VIEW LN
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-8659
Mailing Address - Country:US
Mailing Address - Phone:541-419-8229
Mailing Address - Fax:
Practice Address - Street 1:365 NE COURT ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1936
Practice Address - Country:US
Practice Address - Phone:541-323-5330
Practice Address - Fax:541-447-6694
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR96-10-38101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)